Mechanisms of Non-Genetic Inheritance and Psychiatric Disorders

Inheritance is typically associated with the Mendelian transmission of information from parents to offspring by alleles (DNA sequence). However, empirical data clearly suggest that traits can be acquired from ancestors by mechanisms that do not involve genetic alleles, referred to as non-genetic inheritance. Information that is non-genetically transmitted across generations includes parental experience and exposure to certain environments, but also parental mutations and polymorphisms, because they can change the parental ‘intrinsic’ environment. Non-genetic inheritance is not limited to the first generation of the progeny, but can involve the grandchildren and even further generations. Non-genetic inheritance has been observed for multiple traits including overall development, cardiovascular risk and metabolic symptoms, but this review will focus on the inheritance of behavioral abnormalities pertinent to psychiatric disorders. Multigenerational non-genetic inheritance is often interpreted as the transmission of epigenetic marks, such as DNA methylation and chromatin modifications, via the gametes (transgenerational epigenetic inheritance). However, information can be carried across generations by a large number of bioactive substances, including hormones, cytokines, and even microorganisms, without the involvement of the gametes. We reason that this broader definition of non-genetic inheritance is more appropriate, especially in the context of psychiatric disorders, because of the well-recognized role of parental and early life environmental factors in later life psychopathology. Here we discuss the various forms of non-genetic inheritance in humans and animals, as well as rodent models of psychiatric conditions to illustrate possible mechanisms.     

Local and global structural drivers for the photoactivation of the orange carotenoid protein

Photoprotective mechanisms are of fundamental importance for the survival of photosynthetic organisms. In cyanobacteria, the orange carotenoid protein (OCP), when activated by intense blue light, binds to the light-harvesting antenna and triggers the dissipation of excess captured light energy. Using a combination of small angle X-ray scattering (SAXS), X-ray hydroxyl radical footprinting, circular dichroism, and H/D exchange mass spectrometry, we identified both the local and global structural changes in the OCP upon photoactivation. SAXS and H/D exchange data showed that global tertiary structural changes, including complete domain dissociation, occur upon photoactivation, but with alteration of secondary structure confined to only the N terminus of the OCP. Microsecond radiolytic labeling identified rearrangement of the H-bonding network associated with conserved residues and structural water molecules. Collectively, these data provide experimental evidence for an ensemble of local and global structural changes, upon activation of the OCP, that are essential for photoprotection.Photosynthetic organisms have evolved a protective mechanism known as nonphotochemical quenching (NPQ) to dissipate excess energy, thereby preventing oxidative damage under high light conditions (1). In plants and algae, NPQ involves pH-induced conformation changes in membrane-embedded protein complexes and enzymatic interconversion of carotenoids (2, 3). Cyanobacteria, in contrast, use a relatively simple NPQ mechanism governed by the water soluble orange carotenoid protein (OCP). The OCP is composed of an all α-helical N-terminal domain (NTD) consisting of two discontinuous four-helix bundles and a mixed α/β C-terminal domain (CTD), which is a member of the widely distributed nuclear transport factor 2-like superfamily (Fig. S1A) (4, 5). There are two regions of interaction between the NTD and CTD (4, 5): the major interface, which buries 1,722 Å of surface area, and the interaction between the N-terminal alpha-helix (αA) and the CTD (minor interface) (Fig. S1A). A single noncovalently bound keto-carotenoid [e.g., echinenone (ECN)] spans both domains in the structure of the resting (inactive) form of the protein (OCP^O).Open in a separate windowFig. S1.Structure of the OCP. (A) Crystal structure of Synechocystis OCP (PDB ID code 3MG1) consisting of two domains, NTD and CTD as described in the main text introduction, which form major and minor interfaces. (B) Amino acid residues within 3.9 Å of the carotenoid are shown by sticks. (C) Surface-bound water molecules at the major interface are shown in slate-colored spheres in Synechocystis OCP (PDB ID code 3MG1). This layer of water molecules fully or partially eclipses other water molecules, which are either conserved or found to be at the same location (within 0.5 Å) in the crystal structures of A. maxima and Synechocystis OCP (Fig. 4 A and B. Removal of the slate-colored spheres, exposing partially buried water, is shown in orange in D. The fully buried waters (red spheres) are invisible in the surface diagram of OCP. (E) Cross-sectional view to show the position of fully and partially buried structural waters in OCP^O. (F) Details of water–protein H-bonding network in water cluster 1 at the major interface. The absolutely conserved R155 is closely surrounded (<3.2 Å, capable of forming H-bond) by a number of buried (HOH1151,1200, and 1671) water molecules, which are involved in dense residue-water interactions as discussed in the main text. Similar H-bonding networks are also observed in the water clusters 2 and 3 (6). Exposure to blue light converts OCP^O to the active (red) form, OCP^R (7). OCP^R is involved in protein–protein interactions with the phycobilisome (PB) (5) and the fluorescence recovery protein (FRP), which converts OCP^R back to OCP^O (8). The OCP^R form is therefore central to the photoprotective mechanism, and determining the exact structural changes that accompany its formation are critical for a complete mechanistic understanding of the reversible quenching process in cyanobacteria. Although crystal structures exist of both the (inactive) OCP^O (4, 5) and the active NTD (effector domain) form of the protein (9), crystallization of the activated, full-length OCP^R has not been achieved. To identify the protein structural changes that occur after absorption of light by the OCP’s ECN chromophore, we undertook a hybrid approach to structurally characterize OCP^R in solution.In Synechocystis OCP^O, the 4-keto group on the “β1” ring of ECN is H-bonded to two conserved residues, Y201 and W288, in a hydrophobic pocket in the core of the CTD (Fig. S1B) (5). The other end of the carotenoid is positioned between the two four-helix bundles of the NTD. Several conserved residues within 3.9 Å of the carotenoid are known to interact with its extensive conjugation and result in fine tuning of the spectral characteristics of the OCP (Fig. S1B) (4, 5); these residues have been implicated in photochemical function via mutagenesis studies (5). A recent study of the OCP bound to the carotenoid canthaxanthin (OCP-CAN) showed that photoactivation of the OCP results in a substantial translocation (12 Å) of the carotenoid deeper into the NTD (9). Mutational analyses of the full-length OCP and biochemical studies on the constitutively active NTD [commonly known as the red carotenoid protein (RCP)] suggested that the NTD and CTD at least partially separate, resulting in the breakage of an interdomain salt-bridge (R155–E244) upon photoactivation (9–12). Together, the previous studies suggest that large-scale protein structural changes in the OCP accompany carotenoid translocation upon light activation; however, such changes in the context of the full-length protein have yet to be experimentally demonstrated. Here, we report use of X-ray radiolytic labeling with mass spectrometry (XF-MS) and hydrogen/deuterium exchange with mass spectrometry (HDX-MS), which detect residue-specific changes (13–15), to investigate the structural changes that occur during OCP photoactivation. In conjunction with small angle X-ray scattering (SAXS), which enables characterization of global conformational changes in the solution state (16), we show that dissociation of the NTD and CTD is complete in photoactivated OCP. This separation is accompanied by an unfolding of the N-terminal α-helix that is associated with the CTD in the resting state. We also pinpoint changes in specific amino acids and structurally conserved water molecules, providing insight into the signal propagation pathway from carotenoid to protein surface upon photoactivation. Collectively, these data provide a comprehensive view of both global and local intraprotein structural changes in the OCP upon photoactivation that are essential to a mechanistic understanding of cyanobacterial NPQ.     

Peritoneal Equilibration Test and Patient Outcomes

Background and objectives

Although a peritoneal equilibration test yields data on three parameters (4-hour dialysate/plasma creatinine, 4- to 0-hour dialysate glucose, and 4-hour ultrafiltration volume), all studies have focused on the prognostic value of dialysate/plasma creatinine for patients undergoing peritoneal dialysis. Because dialysate 4- to 0-hour glucose and ultrafiltration volume may be superior in predicting daily ultrafiltration, the likely mechanism for the association of peritoneal equilibration test results with outcomes, we hypothesized that they are superior to dialysate/plasma creatinine for risk prediction.

Design, setting, participants, & measurements

We examined unadjusted and adjusted associations of three peritoneal equilibration test parameters with all-cause mortality, technique failure, and hospitalization rate in 10,142 patients on peritoneal dialysis treated between January 1, 2007 and December 31, 2011 in 764 dialysis facilities operated by a single large dialysis organization in the United States, with a median follow–up period of 15.8 months; 87% were treated with automated peritoneal dialysis.

Results

Demographic and clinical parameters explained only 8% of the variability in dialysate/plasma creatinine. There was a linear association between dialysate/plasma creatinine and mortality (adjusted hazards ratio per 0.1 unit higher, 1.07; 95% confidence interval, 1.02 to 1.13) and hospitalization rate (adjusted incidence rate ratio per 0.1 unit higher, 1.05; 95% confidence interval, 1.03 to 1.06). Dialysate/plasma creatinine and dialysate glucose were highly correlated (r=−0.84) and yielded similar risk prediction. Ultrafiltration volume was inversely related with hospitalization rate but not with all-cause mortality. None of the parameters were associated with technique failure. Adding 4- to 0-hour dialysate glucose, ultrafiltration volume, or both did not result in any improvement in risk prediction with dialysate/plasma creatinine alone.

Conclusions

This analysis from a large contemporary cohort treated primarily with automated peritoneal dialysis validates dialysate/plasma creatinine as a robust predictor of outcomes in patients treated with peritoneal dialysis.     

Timing of Return to Dialysis in Patients with Failing Kidney Transplants

In the last decade, the number of patients starting dialysis after a failed kidney transplant has increased substantially. These patients appear to be different from their transplant‐naïve counterparts, and so may be the timing of dialysis therapy initiation. An increasing number of studies suggest that in transplant‐naïve patients, later dialysis initiation is associated with better outcomes. Very few data are available on timing of dialysis reinitiation in failed transplant recipients, and they suggest that an earlier return to dialysis therapy tended to be associated with worse survival, especially among healthier and younger patients and women. Failed transplant patients may also have unique issues such as continuation of immunosuppression versus withdrawal or the need for remnant allograft nephrectomy with regard to dialysis reinitiation. These patients may have a different predialysis preparation work‐up, worse blood pressure control, higher or lower serum phosphorus levels, lower serum bicarbonate concentration, and worse anemia management. The choice of dialysis modality may also represent an important question for these patients, even though there appears to be no difference in mortality between patients starting peritoneal versus hemodialysis. Finally, failed transplant patients returning to dialysis appear to have a higher mortality rate compared with transplant‐naïve incident dialysis patients, especially in the first several months of dialysis therapy. In this review, we will summarize the available data related to the timing of dialysis initiation and outcomes in failed kidney transplant patients after returning to dialysis.     

Poster 6: Traumatic brain injury as a relevant cause of growth hormone deficiency in adults. Experience from KIMS (pharmacia international metabolic database)

Objective: To compare baseline clinical characteristics and 1-year growth hormone (GH) replacement results in patients with adult onset growth hormone deficiency (GHD) caused by traumatic brain injury (TBI) versus nonfunctioning pituitary adenoma (NFPA). Design: Pharmacoepidemiologic survey of hypopituitary adults with GHD. Setting: Records were selected from the KIMS database, which contains information on >8500 patients with GHD, for 168 of whom TBI was identified as a cause. Participants: Both groups (NFPA group, n=207; TBI group, n=29) were age- (at pituitary disorder onset and entry into the KIMS database) and sex-matched (60% men, 40% women), previously not irradiated, and had not received GH. Interventions: Not applicable. Main Outcome Measures: Values given as mean ± SE. Results: The age at GHD diagnosis was 38.8±2.0 years for the TBI group and 41.5±0.5 years for the NFPA group. In both groups, the most frequent additional hypopituitary deficiency was luteinzing hormone/follicle-stimulating hormone, followed by adrenocorticotropic hormone and thyroid-stimulating hormone. The mean GH peak at diagnosis was 1.25±0.42ng/mL in the TBI group, which was significantly lower than that of the NFPA group (2.38±0.7ng/mL). There were no significant statistical differences in medical history, glucose level, lipids, waist circumference, or body composition measurements. Interestingly, patients with TBI were significantly shorter (168.2±1.5cm) than the NFPA patients (172.5±0.6cm). After 1 year of GH treatment, differences were shown in waist, lean mass, heart rate, glucose levels, quality of life as measured by the Quality of Life Assessment in Growth Hormone Deficient Adults and insulin-like growth factor I. Conclusions: Although hypopituitarism secondary to TBI was described more than 50 years ago, it is only now evident that a considerable number of patients experience severe GHD after TBI. It is suspected that a large number of patients after TBI have undiagnosed GHD. The present results confirm that clinical characteristics and GH treatment effects in GHD caused by TBI are indistinguishable from those in GHD caused by NFPA.